Journal of Clinical and Cellular Immunology
Open Access

Abstract

The T_H17/Treg Imbalance in Rheumatoid Arthritis and Relation to Disease Activity

Taghrid Gaafar, Reem Farid, Hala Raafat, Faten Bayoumi, Botros Gerges and Dina Rasheed

Objectives: T regulatory cells (Treg) and proinflammatory T_H17 cells are newly identified T lymphocyte subsets, which have significant effects on autoimmunity and inflammation. Tregs play key role in the maintenance of self-tolerance. T_H17/Treg disturbed balance has been reported to contribute to several autoimmune diseases.
Our aim was to assess the Treg/T_H17 pattern and T_H17 related cytokines, in peripheral blood of Egyptian rheumatoid arthritis patients, and their relation to disease activity score (DAS). Analyzing IL17A and IL23 as indicators of T_H17 function, was to study the effect of T_H17 in RA.
Methods: 100 Egyptian rheumatoid arthritis patients, divided into Group I (14), Group II (48), Group III (38), with low <3.2, moderate 3.2 to <5.1 and high >5.1, activity DAS score respectively; and 50 healthy age and sex matched controls were enrolled. Peripheral blood T_H17 and Treg (CD4⁺CD25⁺Foxp3⁺) frequencies were analyzed by flowcytometry, and the serum levels of interleukins (IL17A), (IL23) were determined by ELISA.
Results: Active RA patients (groups II and III) revealed an obvious increase in peripheral T_H17 frequencies, and levels of T_H17-related cytokines, and a significant decrease in Treg (CD4⁺CD25⁺Foxp3⁺) frequencies in group III, when compared to healthy controls. T_H17/Treg ratios were positively correlated with serum concentrations of IL17A and IL23 cytokines. Frequencies and levels showed statistical significant correlation with DAS scoring.
Conclusions: Our study indicated that T_H17/Treg balance was disturbed in peripheral blood of RA patients, leading to an increase of proinflammatory cytokines, correlating with DAS, and suggesting an important role in the development of RA.